【摘要】 [目的]分析疫苗衍生脊髓灰质炎病毒(VDPV)病例发病原因并探索控制对策。[方法]对发生的VD-PV病例进行个案调查,检测脊灰抗体,测定免疫功能,并定期采集粪便标本分离病毒;对病例所在地及医院进行急性弛缓性麻痹病例主动搜索;对病例所在地及相邻地开展儿童常规接种率快速评价;对密切接触者和周围健康儿童进行粪便标本带毒率调查和脊灰抗体检测。[结果]病例临床诊断为脊髓灰质炎,最终分类诊断为VDPV病例。当地儿童常规免疫接种率较高,并具有较高的脊灰抗体,粪便标本除分离到3株脊灰病毒外,未检出VDPV。为防止VDPV传播,对患儿采取了隔离、消毒措施,在病例所在地及相邻地区开展OPV强化免疫。[结论]该病毒未在当地造成循环。当前应维持高水平的OPV免疫接种率,但随着全球消灭脊灰的进展,应适时修订免疫策略。更多还原

【Abstract】 [Objective] To analyze the cause of vaccine derived poliovirus (VDPV) cases and explore the control measures. [Methods] The VDPV cases were investigated, whose polio antibody as well as immunity function were detected and stool samples were collected regularly for poliovirus isolation. Meanwhile an active search for acute flaccid paralysis cases was conducted in the area and local hospitals. At the same time, the regular immunization coverage of children in local and near area was evaluated. The poliovirus carried rate of stool samples of close contacts and healthy children were quickly investigated and their polio antibodies were detected. [Results] The clinical diagnosis was poliomyelitis and the final classification diagnosis was vaccine derived poliovirus. The immunization coverages of local children’s were high, and so were their polio antibody levels. No poliovirus was found from stool samples of close contacts and healthy children except for 3 poliovirus strains. To prevent the spread of VDPV, the segregation and sterilization measures were taken for infected children. OPV supplementary immunization were conducted in local and neighboring areas. [Conclusion] The VDPV do not cause virus circulation in local area. High level of OPV vaccination coverage should be maintained but immunization strategy should be modified in time with the development of global polio eradication.更多还原